Similarly, in chronic renal insufficiency BCAA levels are reduced and the authors suggest that these AAs are metabolized to produce glutamine to counter the increase in ammonia (Holeček, 2018), implying that an increase in BCAT2 activity in individuals with liver cirrhosis, urea cycle disorders and chronic renal insufficiency can mitigate the increases in ammonia levels. Here, BCAT2 is linked to chronic kidney disease.